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Smith LE, West R, Potts HWW, Amlôt R, Fear NT, Rubin GJ, Michie S. Factors associated with wearing a facemask in shops in England following removal of a legal requirement to do so during the COVID-19 pandemic. Br J Health Psychol 2024; 29:3-19. [PMID: 37537895 DOI: 10.1111/bjhp.12684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/30/2023] [Accepted: 07/21/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVES We aimed to identify psychological factors associated with the use of facemasks in shops in England following removal of legal requirements to do so, and to compare associations with and without legal restrictions. DESIGN Repeated cross-sectional online surveys (n ≈ 2000 adults) between August 2020 and April 2022 (68,716 responses from 45,682 participants) using quota sampling. METHODS The outcome measure was whether those who had visited a shop for essentials in the previous seven days reported always having worn a facemask versus sometimes or not at all. Psychological predictor variables included worry, perceived risk and severity of COVID-19 and the perceived effectiveness of facemasks. Socio-demographic variables and measures of clinical vulnerability were also measured. For the period following removal of legal restrictions, multivariable regression was used to assess associations between the primary outcome variable and predictors adjusting for socio-demographic and clinical vulnerability measures. The analysis was repeated including interactions between psychological predictors and presence versus absence of legal restrictions. RESULTS Worry about COVID-19, beliefs about risks and severity of COVID-19 and effectiveness of facemasks were substantially and independently associated with the use of facemasks. Removal of legal obligations to wear facemasks was associated with a 25% decrease in wearing facemasks and stronger associations between psychological predictors and wearing facemasks. CONCLUSIONS Legal obligations increase rates of wearing a facemask. Psychological factors associated with wearing a facemask could be targets for interventions aiming to alter rates of wearing a facemask. These interventions may be more effective when there are no legal obligations to wear a face covering in place.
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Affiliation(s)
- Louise E Smith
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, London, UK
| | - Robert West
- Department of Behavioural Science and Health, University College London, London, UK
| | - Henry W W Potts
- Institute of Health Informatics, University College London, London, UK
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, London, UK
- Behavioural Science and Insights Unit, UK Health Security Agency, London, UK
| | - Nicola T Fear
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- King's Centre for Military Health Research and Academic Department of Military Mental Health, King's College London, London, UK
| | - G James Rubin
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, London, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
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Robin C, Reynolds R, Lambert H, Hickman M, Rubin GJ, Smith LE, Yardley L, Cai S, Zhang T, Mook P, McManus O, Lasseter G, Compston P, Denford S, Zhang J, Amlôt R, Oliver I. Understanding adherence to self-isolation in the first phase of the COVID-19 pandemic in England: a cross-sectional mixed-methods study. BMC Public Health 2023; 23:2074. [PMID: 37872611 PMCID: PMC10594856 DOI: 10.1186/s12889-023-16674-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/31/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND During the early "containment" phase of the COVID-19 response in England (January-March 2020), contact tracing was managed by Public Health England (PHE). Adherence to self-isolation during this phase and how people were making those decisions has not previously been determined. The aim of this study was to gain a better understanding of decisions around adherence to self-isolation during the first phase of the COVID-19 response in England. METHODS A mixed-methods cross sectional study was conducted, including an online survey and qualitative interviews. The overall pattern of adherence was described as never leaving home, leaving home for lower-contact reasons and leaving home for higher-contact reasons. Fisher's exact test was used to test associations between adherence and potentially predictive binary factors. Factors showing evidence of association overall were then considered in relation to the three aspects of adherence individually. Qualitative data were analysed using inductive thematic analysis. RESULTS Of 250 respondents who were advised to self-isolate, 63% reported not leaving home at all during their isolation period, 20% reported leaving only for lower-contact activities (dog walking or exercise) and 16% reported leaving for higher-contact, and therefore higher-risk, reasons. Factors associated with adherence to never going out included: the belief that following isolation advice would save lives, experiencing COVID-19 symptoms, being advised to stay in their room, having help from outside and having regular contact by text message from PHE. Factors associated with non-adherence included being angry about the advice to isolate, being unable to get groceries delivered and concerns about losing touch with friends and family. Interviews highlighted that a sense of duty motivated people to adhere to isolation guidance and where people did leave their homes, these decisions were based on rational calculations of the risk of transmission - people would only leave their homes when they thought they were unlikely to come into contact with others. CONCLUSIONS Understanding adherence to isolation and associated reasoning during the early stages of the pandemic is essential to pandemic preparedness for future emerging infectious disease outbreaks. Individuals make complex decisions around adherence by calibrating transmission risks, therefore treating adherence as binary should be avoided.
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Affiliation(s)
- Charlotte Robin
- Behavioural Science and Insights Unit, UK Health Security Agency, Liverpool, L3 1DS, UK.
| | - Rosy Reynolds
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Helen Lambert
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - G James Rubin
- Department of Psychological Medicine, King's College London, London, UK
| | - Louise E Smith
- Department of Psychological Medicine, King's College London, London, UK
| | - Lucy Yardley
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Psychology Department, University of Southampton, Southampton, UK
| | - Shenghan Cai
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Tingting Zhang
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Piers Mook
- UKHSA, Field Service, Health Protection Operations, London, UK
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Oliver McManus
- UKHSA, Field Service, Health Protection Operations, London, UK
| | - Gemma Lasseter
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Polly Compston
- UKHSA, Field Service, Health Protection Operations, Cambridge, UK
| | - Sarah Denford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Juan Zhang
- Department of Anthropology and Archaeology, University of Bristol, Bristol, UK
| | - Richard Amlôt
- Behavioural Science and Insights Unit, UK Health Security Agency, Salisbury, UK
| | - Isabel Oliver
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- UKHSA, Field Service, Health Protection Operations, Bristol, UK
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Smith LE, Potts HW, Brainard J, May T, Oliver I, Amlôt R, Yardley L, Rubin GJ. Did mpox knowledge, attitudes and beliefs affect intended behaviour in the general population and men who are gay, bisexual and who have sex with men? An online cross-sectional survey in the UK. BMJ Open 2023; 13:e070882. [PMID: 37827743 PMCID: PMC10583036 DOI: 10.1136/bmjopen-2022-070882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 09/21/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVES To investigate rates of mpox beliefs, knowledge and intended behaviours in the general population and in gay, bisexual or other men who have sex with men (GBMSM), and factors associated with intended behaviours. To test the impact of motivational messages (vs a factual control) on intended behaviours. DESIGN Cross-sectional online survey including a nested randomised controlled trial. SETTING Data collected from 5 September 2022 to 6 October 2022. PARTICIPANTS Participants were aged 18 years or over and lived in the UK (general population). In addition, GBMSM were male, and gay, bisexual or had sex with men. The general population sample was recruited through a market research company. GBMSM were recruited through a market research company, the dating app Grindr and targeted adverts on Meta (Facebook and Instagram). MAIN OUTCOME MEASURES Intention to self-isolate, seek medical help, stop all sexual contact, share details of recent sexual contacts and accept vaccination. RESULTS Sociodemographic characteristics differed by sample. There was no effect of very brief motivational messaging on behavioural intentions. Respondents from Grindr and Meta were more likely to intend to seek help immediately, completely stop sexual behaviour and be vaccinated or intend to be vaccinated, but being less likely to intend to self-isolate (ps<0.001). In the general population sample, intending to carry out protective behaviours was generally associated with being female, older, having less financial hardship, greater worry, higher perceived risk to others and higher perceived susceptibility to and severity of mpox (ps<0.001). There were fewer associations with behaviours in the Grindr sample, possibly due to reduced power. CONCLUSIONS GBMSM were more likely to intend to enact protective behaviours, except for self-isolation. This may reflect targeted public health efforts and engagement with this group. Associations with socioeconomic factors suggest that providing financial support may encourage people to engage with protective behaviours.
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Affiliation(s)
- Louise E Smith
- Department of Psychological Medicine, King's College London, London, UK
| | - Henry Ww Potts
- Institute of Health Informatics, University College London, London, UK
| | - Julii Brainard
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Tom May
- School of Psychological Science, University of Bristol, Bristol, UK
| | | | | | - Lucy Yardley
- School of Psychological Science, University of Bristol, Bristol, UK
| | - G James Rubin
- Department of Psychological Medicine, King's College London, London, UK
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Van Der Zant T. Worry About COVID-19 and Other Extreme Events Amongst Educators in Australia. AUSTRALIAN JOURNAL OF EDUCATION 2023; 67:143-162. [PMID: 38602924 PMCID: PMC10133864 DOI: 10.1177/00049441231168447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
The significant disruption of COVID-19 on schooling has heightened concerns about its impact on educators' wellbeing. The current study examined how educators' worry regarding the COVID-19 pandemic compared to their worry about other extreme events, such as natural disasters and critical incidents (a death or suicide of a child, young person, or colleague). Educators report that they were most worried about COVID-19. Educators working in preschools were more worried about COVID-19 and natural disasters than those in primary and secondary schools. However, worry regarding critical incidents increased with the age of students taught. Worry was influenced by socio-economic advantage (SEIFA), whereby educators working in higher SEIFA communities were less worried about natural disasters and critical incidents but shared similar levels of worry about COVID-19 as educators in lower SEIFA communities. With a better understanding about how different types of worry and levels of worry vary across different educator groups and different contexts, more effective supports can be developed and offered.
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Andersson EM, Norberg M. Reactions for actions? Trust in protective behaviors and safeguarding measures in the early phase of the Covid-19 pandemic in Sweden. Prev Med Rep 2023; 32:102133. [PMID: 36785742 PMCID: PMC9908563 DOI: 10.1016/j.pmedr.2023.102133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
To minimize the spread of Covid-19, changing every-day behavior has been key. Trust in the effectiveness of individual protective measures (response efficacy) and confidence in collective safeguarding measures (strategy efficacy), offers an incitement for acting adequately. Efficacy beliefs of protective measures might be especially relevant to study in the Swedish context, since Sweden, in contrast to countries facing hard lock-downs, launched safeguarding measures based on individual responsibility and voluntary actions. We aimed to assess associations between on the one hand, response efficacy and strategy efficacy, and on the other hand, propensity for behavior change and support of protective measures. Furthermore, to assess associations between the efficacy beliefs and comprehension of and confidence in information about the virus, prosocial beliefs and worry of Covid-19. Reactions were assessed in a Swedish sample close in time to experiences via the SEMA3 app from March 25th to May 17th 2020. Study participants had replied to questions on strategy efficacy (n = 175) or response efficacy (n = 157) and 146 participants had replied to both. High response efficacy was associated with propensity for behavior change, support of protective measures and confidence in Covid-19 information. Low strategy efficacy was associated with lower comprehension of and confidence in information about Covid-19. The results suggest that strengthening efficacy beliefs can be a way to promote protective behaviors. Furthermore, the result underscores the importance of information being easy to understand and trustworthy. Finding ways to increase public understanding of the effectiveness of protective measures, including vaccination, seems crucial in pandemic times.
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Affiliation(s)
- Elin M. Andersson
- Department of Psychology, Umeå University, Umeå, Sweden,Corresponding author at: Department of Psychology, S-901 87 Umeå, Sweden
| | - Margareta Norberg
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Ren F, Liu J, Miao J, Xu Y, Zhang R, Fan J, Lin W. Public awareness, specific knowledge, and worry about mpox (monkeypox): A preliminary community-based study in Shenzhen, China. Front Public Health 2023; 11:1077564. [PMID: 36866102 PMCID: PMC9971966 DOI: 10.3389/fpubh.2023.1077564] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 01/30/2023] [Indexed: 02/16/2023] Open
Abstract
Background The mpox (monkeypox) outbreak has been declared to be a public health emergency of international concern by the Director-General of World Health Organization in July 2022. However, evidence regarding the awareness, knowledge, and worry about mpox in the general population remains scant. Methods A community-based survey targeting community residents was preliminarily conducted in Shenzhen, China in August 2022 by using a convenience sampling method. Information on mpox-related awareness, knowledge, and worry was collected from each participant. Binary logistic regression analyses with the stepwise procedure were applied to explore the factors associated with awareness, knowledge, and worry about mpox. Results A total of 1028 community residents were included in the analysis (mean age: 34.70 years). Among these participants, 77.9% had ever heard of mpox, and 65.3% were aware of the global outbreak of mpox. However, only about half of them had a high level of knowledge regarding mpox (56.5%) and related symptoms (49.7%). More than one-third of them (37.1%) expressed a high level of worry about mpox. Having high knowledge levels of mpox and related symptoms were positively associated with a high level of worry (OR: 1.79, 95%CI: 1.22~2.63 for a single high knowledge level; OR: 1.98, 95%CI: 1.47~2.66 for both high knowledge levels). Conclusions This study identified the gaps in public awareness and specific knowledge of mpox in Chinese people, providing scientific evidence for the prevention and control network of mpox at the community level. Targeted health education programs are of urgent need, which should be implemented along with psychological interventions to release public worry if necessary.
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Affiliation(s)
- Fangmei Ren
- Gushu Community Health Service Center, Baoan Central Hospital of Shenzhen, Shenzhen, China
| | - Junchao Liu
- Haicheng Community Health Service Center, Baoan Central Hospital of Shenzhen, Shenzhen, China
| | - Jianping Miao
- Gushu Community Health Service Center, Baoan Central Hospital of Shenzhen, Shenzhen, China
| | - Yucheng Xu
- Emergency Office, Futian District Center for Disease Control and Prevention, Shenzhen, China
| | - Ruiyin Zhang
- Department of Programme Immunization, Futian District Center for Disease Control and Prevention, Shenzhen, China
| | - Jingjie Fan
- Department of Preventive Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China,*Correspondence: Jingjie Fan ✉
| | - Wei Lin
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China,Wei Lin ✉
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Schulz-Stübner S, Hauer T, Nopper K. [Experiences and Resilience of Hygiene Team Members During the SARS-CoV-2 Pandemic]. DAS GESUNDHEITSWESEN 2022. [PMID: 36084946 DOI: 10.1055/a-1851-4287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND In compliance with German data protections regulations, we conducted an anonymous survey among participants of the annual infectious disease and control meeting in Freiburg, Germany in October 2021. MATERIAL AND METHODS We report the results of nurse and physician members of infection control teams on their perceptions and emotions during the pandemic. Descriptive statistics and Chi Square Test with P<0.05 (SPSS Statistics Standard Version) were used when applicable. RESULTS Of the 391 of 750 distributed surveys, 391 were returned; 48% were infection control practitioners (IP), 12% Link Nurses (LN), 12% Board Certified Hospital Epidemiologists (HE), 17% infection control-trained physicians (ITP), 1% Occupational Health or Public Health specialists and 10% others. 72% were female, 25.3% male, 0.2% divers and 2.5% gave no answers. The 349 members of infection control teams (IP, LN, HE, ITP) reported a high level of competency, importance and appreciation and a low rate of anxiety or hopelessness. A quarter reported anger and frustration which nevertheless did not result in reduced motivation. Information provided by the German national health agency Robert Koch-Institute (RKI) was utilized most by participants. Social media, on the other hand, were criticized frequently. Cooperation within the institution and local public health authorities was good. Free text answers regarding lessons learned showed wide potential for improvement. CONCLUSION Our survey results indicate a high level of resilience among members of infection control teams in German medical institutions despite obvious shortcomings in supplies during the first wave of the pandemic. The high level of self-perceived competency and appreciation possibly helped deal with the situation and prevented the feeling of loss of control implied in the question items "feeling overwhelmed" and "hopeless". However, the lessons learned from the pandemic need to be implemented to maintain this high level of resilience not only for infection control teams but the medical system in general.
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Affiliation(s)
- Sebastian Schulz-Stübner
- Wissenschaftlicher Dienst, Deutsches Beratungszentrum für Hygiene (BZH GmbH), Freiburg, Germany.,Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Freiburg Medizinische Universitätsklinik, Freiburg im Breisgau, Germany.,Gesundheitspädagogik, Pädagogische Hochschule Freiburg, Freiburg im Breisgau, Germany
| | - Thomas Hauer
- Hygiene, Deutsches Beratungszentrum für Hygiene (BZH GmbH), Freiburg, Germany
| | - Katharina Nopper
- Akademie, Deutsches Beratungszentrum für Hygiene (BZH GmbH), Freiburg, Germany
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Power N, Warmelink L, Wallace R. Prosocial rule breaking, ingroups and social norms: Parental decision-making about COVID-19 rule breaking in the UK. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2022; 33:CASP2650. [PMID: 36249595 PMCID: PMC9537870 DOI: 10.1002/casp.2650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/30/2022]
Abstract
The British public generally adhered to COVID-19-related restrictions, but as the pandemic drew on, it became challenging for some populations. Parents with young children were identified as a vulnerable group. We collected rich, mixed-methods survey data from 99 UK-based parents (91 mothers) of children under 12, who described their lockdown transgressions. Household mixing was the most prevalent broken rule. Template analysis found that rule breaking was driven by 'ingroup-level' prosocial motivations to protect the mental and social health of family and loved ones, and that parents were 'engaged' decision-makers who underwent careful deliberation when deciding to break rules, making trade-offs, bending rules, mitigating risks, reaching consensus, and reacting to perceived rule injustices. Cumulative link models found that the perceived reasonableness of rule violations was predicted by social norms. Rules were broken by parents not for antisocial reasons, but for 'ingroup-level' prosocial reasons, linked to supporting loved ones.
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Affiliation(s)
- Nicola Power
- Department of Psychology, Fylde CollegeLancaster UniversityLancasterUK
| | - Lara Warmelink
- Department of Psychology, Fylde CollegeLancaster UniversityLancasterUK
| | - Rebecca Wallace
- Department of Psychology, Fylde CollegeLancaster UniversityLancasterUK
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Dumas TM, Ellis WE, Van Hedger S, Litt DM, MacDonald M. Lockdown, bottoms up? Changes in adolescent substance use across the COVID-19 pandemic. Addict Behav 2022; 131:107326. [PMID: 35397263 PMCID: PMC8962194 DOI: 10.1016/j.addbeh.2022.107326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 11/27/2022]
Abstract
The COVID-19 pandemic notably altered adolescent substance use during the initial stage (Spring 2020) of the pandemic. The purpose of this longitudinal study is to examine trajectories of adolescent substance use across the pandemic and subsequent periods of stay-at-home orders and re-opening efforts. We further examined differences as a function of current high school student versus graduate status. Adolescents (n = 1068, 14–18 years, Mage = 16.95 years and 76.7% female at T1) completed 4 different self-report surveys, starting during the first stay-at-home order and ending approximately 14 months later. Negative binomial hurdle models predicted: (1) the likelihood of no substance use and (2) frequency of days of substance use. As hypothesized, results demonstrated significant increases in adolescents’ likelihood of alcohol use, binge drinking, and cannabis use once initial stay-at-home orders were lifted, yet few changes occurred as a result of a second stay-at-home order, with rates never lowering again to that of the first lockdown. Further, graduates (and particularly those who transitioned out of high school during the study) demonstrated a greater likelihood and frequency of substance use and were more stable in their trajectories across periods of stay-at-home orders than current high school students. Unexpectedly, however, there was a strong increase in current high school students’ likelihood of e-cigarette use and a significant linear increase in participants’ frequency of e-cigarette use over the study. Results suggest adolescent substance use, and in particular, e-cigarette use among current high school students, may be of increasing concern as the pandemic evolves.
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Woodland L, Hodson A, Webster RK, Amlôt R, Smith LE, Rubin J. A Qualitative Study Evaluating the Factors Affecting Families' Adherence to the First COVID-19 Lockdown in England Using the COM-B Model and TDF. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127305. [PMID: 35742548 PMCID: PMC9223726 DOI: 10.3390/ijerph19127305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/08/2022] [Accepted: 06/13/2022] [Indexed: 12/04/2022]
Abstract
The ability of families to adhere to public health guidance is critical to controlling a pandemic. We conducted qualitative interviews with 30 parents of children aged 18 and under, between 16 and 21 April 2020 when schools in England were closed due to the COVID-19 pandemic. Using the Theoretical Domains Framework, we classified the factors that influenced adherence to seven non-pharmaceutical interventions. We found 40 factors that influenced a family’s ability to adhere. Parents generally indicated they could adhere and reported how their family had changed their behaviour to comply with the guidance. Parents primarily reported they were motivated to adhere out of concern for the health consequences of COVID-19, and because the guidance was delivered by the government. However, we found that reduced access to resources (e.g., technology, transport, and outside space) and social influences that encouraged non-adherent behaviour, decreased adherence. Furthermore, we suggest that families with low psychological and physical ability may face additional challenges to adherence and need to be supported. During future school closures, public health agencies should account for these factors when developing guidance.
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Affiliation(s)
- Lisa Woodland
- Department of Psychological Medicine, King’s College London, NIHR Health Protection Unit in Emergency Preparedness and Response, London SE5 9RJ, UK; (L.E.S.); (J.R.)
- Correspondence:
| | - Ava Hodson
- Department of War Studies, King’s College London, NIHR Health Protection Unit in Emergency Preparedness and Response, London WC2R 2LS, UK;
| | - Rebecca K. Webster
- Department of Psychology, University of Sheffield, Sheffield S10 2LT, UK;
| | - Richard Amlôt
- Behavioural Science and Insights Unit, UK Health Security Agency, Porton Down, NIHR Health Protection Unit in Emergency Preparedness and Response, Salisbury SP4 0JG, UK;
| | - Louise E. Smith
- Department of Psychological Medicine, King’s College London, NIHR Health Protection Unit in Emergency Preparedness and Response, London SE5 9RJ, UK; (L.E.S.); (J.R.)
| | - James Rubin
- Department of Psychological Medicine, King’s College London, NIHR Health Protection Unit in Emergency Preparedness and Response, London SE5 9RJ, UK; (L.E.S.); (J.R.)
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Tiered restrictions for COVID-19 in England: knowledge, motivation, and self-reported behaviour. Public Health 2022; 204:33-39. [PMID: 35144152 PMCID: PMC8820758 DOI: 10.1016/j.puhe.2021.12.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 12/15/2021] [Accepted: 12/21/2021] [Indexed: 11/25/2022]
Abstract
Objectives To test whether public knowledge and confidence in one's understanding of the local restrictions, motivation to adhere to local restrictions, and self-reported behaviour (going out for exercise, to work, socially) differed according to tier level. Study design Cross-sectional, nationally representative, online survey of 1728 participants living in England (data collection: 26 to 28 October 2020). Methods We conducted logistic regression analyses to investigate whether knowledge of restrictions, confidence in knowledge of restrictions, motivation to adhere to restrictions, and self-reported behaviour were associated with personal characteristics and tier. Results Between 81% (tier 2) and 89% (tier 3) of participants correctly identified which tier they lived in. Knowledge of specific restrictions was variable. 73% were confident that they understood which tier was in place in their local area, whereas 71% were confident they understood the guidance in their local area. Confidence was associated with being older and living in a less deprived area. 73% were motivated to adhere to restrictions in their local area. Motivation was associated with being female and older. People living in tiers with greater restrictions were less likely to report going out to meet people from another household socially; reported rates of going out for exercise and for work did not differ. Conclusions Although recognition of local tier level was high, knowledge of specific guidance for tiers was variable. There was some indication that nuanced guidance (e.g. behaviour allowed in some settings but not others) was more poorly understood than guidance which was absolute (i.e. behaviour is either allowed or not allowed).
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